Monday, June 13, 2011

Anti-Smoking Advocates Decry Major Smoking Cessation Effort

In an article published online ahead of print in the journal Tobacco Control, a group of tobacco control researchers are attacking electronic cigarette companies for promoting their products by partnering with the entertainment industry and celebrities (see: Grana RA, Glantz SA, Ling PM. Electronic nicotine delivery systems in the hands of Hollywood. Tobacco Control, June 9, 2011).

The article decries the use of an electronic cigarette by Katherine Heigl during her appearance on "The Late Show with David Lettermen," where she stated that she was using the device to quit smoking. It also decries the featuring of electronic cigarettes as a health innovation on the talk show "The Doctors."

According to the article: "In the past, the tobacco industry has partnered with entertainment executives and celebrities to employ several strategies to promote their products in television, movies and popular culture, including cross promotion, product placement and systematic supply of free products to entertainment industry members. It appears that the ENDS [electronic nicotine delivery systems] manufacturers are adopting similar tactics. Given the substantial research demonstrating the effect of viewing smoking in the movies on adolescent smoking initiation, the addictive nature of nicotine and the lack of regulatory assurance of their quality or safety, it is important to keep ENDS, and other similar products, from being sensationalized through the use of celebrity promotion or product placement in movies or other entertainment media."

The Rest of the Story

First, it is not clear to me that this situation is analogous to the tobacco industry's partnerships with Hollywood to promote cigarette smoking because I am aware of no evidence that these depictions of vaping on television were paid for by electronic cigarette companies. Is it not possible that Katherine Heigl decided to demonstrate vaping on television on her own, rather than as a result of having received an electronic cigarette company payment to do so? And is it not possible that the physicians on "The Doctors" actually believe that electronic cigarettes are an important health-related innovation, rather than that they were paid off by e-cigarette manufacturers to promote these devices?

Since the article presents no evidence to support its contention that the electronic cigarette companies had a hand in either of these events, I find its conclusion that the electronic cigarette companies are behind these depictions to be unsupported and therefore inappropriate.

More importantly, though, the paper seems to miss the point. The promotion of electronic cigarettes in the entertainment media and by celebrities is a bad thing only if these devices are actually ineffective for smoking cessation and/or significantly harmful to users. If they are much less harmful than cigarettes and they are helping people to quit smoking, then the promotion of this product in the entertainment media and by celebrities is a great thing and it could save thousands of lives.

The best available evidence at the present time supports the conclusion that electronic cigarettes are much safer than cigarettes and that they are helping thousands of ex-smokers to stay off tobacco cigarettes. Thus, it is most likely the case that the promotion of electronic cigarettes on entertainment television is a good thing because it may be stimulating smokers to quit by trying these unique devices.

In essence, these researchers are criticizing an intervention that is encouraging people to quit smoking. Why would we want to do this? Isn't smoking cessation something we should be encouraging, not attacking?

The problem, of course, is that smokers are not quitting the way we want them to quit. It is not about quitting smoking, it is about quitting smoking the right way. Our way. The way that lines our pockets because of the numerous financial contributions that pharmaceutical companies make to anti-smoking organizations. The way that expert panel members who received payments from these pharmaceutical companies recommend. The way that is least effective because the success rate of NRT treatment is so dismally low.

I guess if it threatens the coffers of anti-smoking organizations, then it's not the right way to quit. And if it simulates smoking - even if much safer - it's definitely not the right way to quit, no matter how effective it may be.

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